PSA - Skin Cancer - I Was “Punched” Yesterday
TW - description of an invasive medical procedure, photo of stitches
No, nobody hit me with a fist, my doctor did a punch biopsy for a suspicious patch of skin on my arm. Full description of the whys and wherefores of a punch biopsy can be found here.
Skin Cancer History
I was first diagnosed with skin cancer a few years ago and have had two lesions removed so far.
The first one was a flaky area near my mouth. At first my doc tried using liquid nitrogen. When that was ineffective, she prescribed a chemotherapy cream commonly known as 5-FU aka Fluorouracil. (Yes, I got a chuckle from the FU part.) It worked and no further action was necessary. There is no scarring from the cream, it looks the same as the rest of the area.
The second one was a rough patch in my eyebrow in late 2021. It was too close to my eye to use anything like liquid nitrogen or chemo cream so I was sent to a local plastic surgeon who removed the lesion.
It was done in the hospital with a local anaesthetic, it took hardly any time at all. It was sent for a biopsy to make sure they got it all (they did). Again, no further action necessary.
My eyebrow is intact, no visible scar.
You can see a discoloured patch below the eye. That has been flaking and I have been referred to the same plastic surgeon.
The Punch
The one on my arm was an irregularly shaped "freckle". It was smooth, not raised, but given my family history (2 first degree relatives, one second degree) my doc did not want to take any chances.
The area was frozen beforehand which was the worst part of the procedure - I felt nothing after that. Doc used a 6mm punch tool which is about the size of a pencil eraser, shoving it in and twisting it to make sure she got the entire spot. Doc told me that melanoma tends to go deep and since we did not know what this was (if it was anything), they wanted to make sure they got it all.
Doc threw a couple of stitches in. They explained that it looks puckered because when the stitches are taken out, it will be flat. If the stitches are sewn flat, there will often be an indent.
The biopsy sample will be sent to a local lab and the results should be back by next week. Sometimes it needs to go to Calgary and that will take a few weeks.
Next Steps
If they got it all, usually nothing more needs to be done except to stay vigilant.
If they did not get it all, it would mean a return to see the doc.
(I am not worried, no need to send well-wishes.)
Why This Happened
Most people have never seen me with a tan (never mind a burn) so why did this happen?
This is from skin damage done decades ago when I was young and foolish and desired a tan. There was no such thing as sunscreen when I was a teen, everyone was using baby oil to get the perfect tan. I did get a burn or two back then before learning that there was no such thing as a “healthy tan".
A tan is the body’s response to damage caused by UV rays. It also ages people’s skin much quicker - I am 62 yo, most people do not believe me when I tell them.
What You Can Do To Protect Yourself
Your skin is your largest organ, protect it by avoiding UV exposure whether it is from the sun or tanning booths. Inspect your skin monthly. Get a doc to check it at least once a year or more often if you are concerned about certain spots.
Look for these "ABCDE" warning signs:
Asymmetry. Do the two halves not match if you imagine drawing a line through the mole?
Borders. Are the edges uneven, scalloped or notched?
Colours. Are there many shades (brown, red, white, blue or black)?
Diameter greater than 6mm. Is the mole the size of a pencil eraser or larger?
Evolution. Has there been a change in size, shape, color, or height? Has a new symptom developed (like bleeding, itching or crusting)?
(Source Gov’t of Canada)
Skin cancer is the most common cancer in Canada, accounting for about ⅓ of all new cancer cases. If discovered at the basal cell or squamous cell stage, it is easily cured. Once it gets to the melanoma stage it is more difficult. The important part is to discover it before it has a chance to spread.
The amount of people getting skin cancer has been increasing in Canada at a fairly constant rate over the past 30 years. Based on current rates, one in 73 Canadian women will develop melanoma during their lifetime while one in 59 Canadian men will develop the disease. (Source Gov’t of Canada)
In the meantime, do the whole “Slip, Slap, Slop” thing.
SLIP on a shirt
SLAP on a hat
SLOP on sunscreen
Don’t forget to protect your eyes with sunglasses meant to block both UVA and UVB rays.
Winter is Coming, Who Needs Sunscreen?
You do!
You might think that summer is over, nobody needs sunscreen now. Winter can actually increase your UV exposure - reflection of UV rays from snow can double your exposure, especially if you are doing some high altitude skiing. Wear sunglasses and put sunscreen on exposed skin.
